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American Cancer Society Guidelines

The American Cancer Society recommends the following guidelines for cancer screening for adults. Use the guidelines to talk with your doctor about your health and lifestyle choices. Together you can determine which screening tests are right for you and how often you should have them.

In addition to the specific tests below, doctors should also perform an occasional exam for signs of cancer of the thyroid, oral cavity, skin, lymph nodes, testes and ovaries, depending on the age and sex of the patient.

Breast Cancer
  • Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
  • Clinical breast exam (CBE) is recommended about every three years for women in their 20s and 30s and every year for women 40 and over.
  • Women should know how their breasts normally look and feel and report any changes promptly to their health-care provider. Breast self-exam (BSE) is an option for women starting in their 20s.

The American Cancer Society recommends that some women – because of their family history, a genetic tendency or certain other factors – be screened with magnetic resonance imaging (MRI) in addition to mammograms. (The number of women who fall into this category is small: less than 2 percent of all the women in the United States.) Talk with your doctor about your history and whether you should have additional tests at an earlier age.

Colorectal Cancer and Polyps

Beginning at age 50, both men and women should follow one of these testing schedules:

Tests That Find Polyps and Cancer

  • Flexible sigmoidoscopy every five years* OR
  • Colonoscopy every 10 years OR
  • Double-contrast barium enema every five years* OR
  • CT colonography (virtual colonoscopy) every five years*

Tests That Primarily Find Cancer

  • Yearly fecal occult blood test (gFOBT)** OR
  • Yearly fecal immunochemical test (FIT)** OR
  • Stool DNA test (sDNA), interval uncertain**

* If the test is positive, a colonoscopy should be done.

** The multiple stool take-home test should be used. One test done by the doctor in the office is not adequate for testing. A colonoscopy should be done if the test is positive.

The tests that are designed to find both early cancer and polyps are preferred if they are available to you and you are willing to have one of these more invasive tests. Talk to your doctor about which test is best for you.

The American Cancer Society recommends that some people be screened using a different schedule because of their personal history or family history. Talk with your doctor about your history and what colorectal cancer screening schedule is best for you.

Cervical Cancer
  • Screening should begin at at 21. Women under the age of 21 should not be tested.
  • Women between the ages of 21 and 29 should have a Pap test every three years. Human papillomavirus (HPV) testing should not be used in this age group unless it is needed after an abnormal Pap test result.
  • Women between the ages of 30 and 65 should have a Pap test plus an HPV test every five years. This is the preferred approach, but it is also OK to have a Pap test alone every three years.
  • Women over age 65 who have had regular cervical cancer testing with normal results should not be tested. Once testing has stopped, it should not be started again. Women with a history of serious cervical precancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past the age of 65.
  •  Women who have had a total hysterectomy (removal of the uterus and cervix) for reasons not related to cervical cancer and who have no history of cervical cancer or serious precancer should not be tested.
  • Women who have been vaccinated against HPV should still follow the screening recommendations for their age group.

Because of their history, some women may need to have a different screening schedule for cervical cancer.

Endometrial (Uterine) Cancer

At the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer. Women should report any unexpected bleeding or spotting to their doctors.

Because of their history, some women may need to consider having a yearly endometrial biopsy. Please talk with your doctor about your history.

Prostate Cancer

Men should make an informed decision with their doctor about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. The American Cancer Society believes men should not be tested without learning about what we know and don’t know about the risks and possible benefits of testing and treatment.

Starting at age 50, men should talk to their doctor about the pros and cons of testing so they can decide if testing is the right choice for them. Men who are are African-American or have a father or brother who had prostate cancer before age 65 should have this talk with their doctor starting at age 45. Men who decide to be tested should have the PSA blood test with or without a rectal exam. How often a man is tested will depend on his PSA level.

Copyright 2012 © American Cancer Society